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Man with hepatitis awaits liver transplant

July 28, 2003|by KATE COLEMAN

katec@herald-mail.com

John W. Kesecker, 47, needs help.

He's tall and looks strong, but Kesecker is sick.

About three years ago, he was diagnosed with hepatitis C, and a severely damaged liver. The virus that leads to the condition causes cirrhosis - irreversible growth of scar tissue - of the liver.

The liver makes the blood's platelets, it clears toxins from the body, it's an "energy storage tank," says Linda Ridge, nurse and transplant coordinator at University of Maryland Medical Center in Baltimore.

Kesecker's illness is suspected to have been caused by a 1977 blood transfusion needed when he lost part of his leg in a work-related accident.

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His illness has caused so much damage to his liver that he needs a new one to survive the illness.

He's on a waiting list for a liver transplant at University of Maryland Medical Center.

The procedure costs approximately $150,000 to $200,000 - just for the surgery and hospitalization, Ridge says. That does not include follow-up care or immunotherapy. The cost of medications can run as high as $3,000 a month, she adds.

Kesecker says he'll have to take 19 to 20 pills every day for the rest of his life.

A 2002 estimate of billed first-year charges for a liver transplant is $313,600, according to information on www.milliman.com, the Web site of Milliman USA, an international consulting and actuarial firm.

Although he is sick - he also has diabetes - Kesecker works as an equipment operator. He needs the health insurance through his employer, but it only provides limited coverage.

The Keseckers have turned to the National Transplant Assistance Fund Inc., a 20-year-old nonprofit organization that provides information, fund-raising advice and medical assistance grants to organ and tissue transplant patients, as well as those with catastrophic injuries.

They are trying to raise money, so far planning a bake sale and a car wash.

Clear Spring residents, John Kesecker and his wife, Ranae, have been married 25 years. They have three daughters, seven grandchildren - one of whom, 11-year-old Christopher - they are raising.

Grandchildren - ranging in age from 2 to 11 - are frequent visitors.

"It's never a dull house," Ranae Kesecker says. The family loves to camp and is planning a reunion at Rocky Gap in Maryland.

Meanwhile, John Kesecker waits for a liver.

Waiting is an emotional roller coaster for patients and their families, Ridge says.

Some stop living and just wait, she says. She advises them not to do that.

About 25 to 35 liver transplants a year are done at the University of Maryland Medical Center, Ridge says.

"The sad statistic is that 25 to 35 (people) die on the waiting list," she adds.

Although the liver donor and liver recipient don't have to be an exact match, there are compatibility requirements. They must be approximately the same height and weight, and they usually have the same or compatible blood types, according to the Web site of the USC (University of Southern California) Liver Transplant Program and Center for Liver Disease, www.livertransplant.org.

Yet, there is a shortage of donated livers.

A potential recipient does not move up on the waiting list as people who receive transplants move off the list. A patient's place on the waiting list is determined by his or her MELD score - Mortality End-Stage Liver Disease - a mathematical formula, Ridge says.

There's a window of opportunity for a liver transplant, Ridge says. You have to get sicker to move up on the list. But if you get too sick, you will miss the opportunity. You could be too sick for the surgery, she explains.

Ridge also tells her patients that the liver transplant - if they can get one - doesn't come with a guarantee.

The obstacles and challenges facing people waiting for a liver transplant are huge.

"I encourage them to live," Ridge says.

Does she encourage them to hope?

"I do."

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